Linkfest Today

Controlling healthcare spending is one of the more difficult obstacles in the current health reform efforts. There is no shortage of opinions, but one oft-overlooked avenue is addressing the malpractice system. One common complaint from doctors is that they can be sued for negative outcomes, which can occur despite exceptional care. Because of the uncertainty surrounding these outcomes of malpractice cases, doctors practice defensive medicine, which increases health costs. Consider severe birth injuries as one example. An op-ed in The New York Times makes a good suggestion to pull these cases from the court system. States like Florida and Virginia have experimented with such an idea, which can accomplish two things: i) speed up payments to patients and families who were affected by birth injuries; and, ii) more fairly determine whether doctors were really at fault in these, often tragic, cases.

Medicare has been increasing their use of so-called "no-pay" events, where payment is denied for preventable, catastrophic, medical errors. But, when it comes to patient falls, is the solution worse than the disease? Perhaps so. The trouble is there is no solid evidence suggesting a best practice to definitively reduce the incidence of falls. And, in this opinion piece from The New England Journal of Medicine, the authors write that, "Of greatest concern is that the heightened focus on fall prevention will probably have unintended consequences. If hospitals are scrutinized for the occurrence of falls, the natural tendency will be to focus on such events even at the expense of competing (and perhaps more important) outcomes. Unintended consequences are likely to include a decrease in mobility and a resurgence in the use of physical restraints in a misguided effort to prevent fall-related injuries." Indeed.